How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,259 to $9,772Professionalmedian $776 · 10th to 90th $603 to $1,202
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $6,165.95 | Facility | None | $758.58 | $2,570.40 | $6,165.95 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | None | $691.83 | $691.83 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $7,762.47 Typical High $10,715.19 | Facility | None | $4,570.88 | $7,762.47 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,318.26 | Professional | None | $707.95 | $812.83 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $5,128.61 Typical High $7,244.36 | Facility | None | $616.60 | $5,128.61 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,230.27 | Professional | None | $602.56 | $616.60 | $1,230.27 |
Hometown Health Setting Professional Modifier None Typical Low $15.14 Median $645.65 Typical High $1,122.02 | Professional | None | $15.14 | $645.65 | $1,122.02 |
Hometown Health Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Hometown Health Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $977.24 | Professional | None | $11.48 | $11.48 | $977.24 |
Select Health Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $4,265.80 | Facility | None | $645.65 | $645.65 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $1,318.26 | Professional | None | $524.81 | $645.65 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,096.48 | Professional | None | $616.60 | $776.25 | $1,096.48 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $524.81 |
Where Nevada sits
The same service costs 6.1 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $13,882MT $2,270
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.